Individual provider Active NPI

Tiffany Walker, PA-C

  • Physician Assistant
  • Edmonds, WA
National Provider Identifier
1649691064
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60536580 Issued in WA
Practice address
21601 76TH Ave W
Edmonds, WA 98026-7507
Phone
(425) 640-4682
NPI assigned
Jan 3, 2014
Last updated
Jan 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60536580 WA Primary

Addresses

Primary practice location

21601 76TH Ave W
Edmonds, WA 98026-7507

Mailing address

28538 75TH Dr NW
Stanwood, WA 98292-8149
Phone (206) 795-3956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150908000778 WA Practitioner - Physician Assistant 6305075268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone (360) 428-2500

2320 Fwy Dr
Mount Vernon, WA 98273-5445
Phone (360) 814-6800

3823 172ND St NE
Arlington, WA 98223-7735
Phone (360) 651-8365

901 S 5TH St
Mount Vernon, WA 98274-3942
Phone (360) 428-6434

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Mar 22, 2024 Accepting new patients
Cep America LLC CurrentSince Jun 16, 2015 Accepting new patients
Cep America LLC CurrentSince Jun 16, 2015 Accepting new patients
Mount Vernon Emergency Group PC Physician Assistant Past Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3823 172nd St NE
Arlington, WA 98223
Phone (360) 618-5000

21601 76th Ave W
Edmonds, WA 98026
Phone (425) 640-4000

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

2320 Freeway Dr
Mount Vernon, WA 98273
Phone (360) 814-6800

901 S 5th St
Mount Vernon, WA 98274
Phone (360) 428-6434

Interoperability endpoints

  • Direct secure messaging: twalker46451@skagit.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1649691064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28538 75TH DR NW",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982928149",
            "telephone_number": "206-795-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21601 76TH AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267507",
            "telephone_number": "425-640-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "TIFFANY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-03",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60536580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.